Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

34 male peptic ulcer patients were compared to (a) a group of 37 healthy controls and (b) a group of 36 hospitalized controls suffering from illnesses unrelated to the gastrointestinal tract. Patients and controls were submitted to the Eysenck personality inventory, Foulds' hostility questionnaire, Langner's 22-item questionnaire, the Hopkins symptom checklist, Zung's self-rating anxiety scale, Spielberger's state-trait anxiety inventory, Zung's and Beck's rating scales for depression, and the 43-item life event inventory by Holmes and Rahe. All patients suffered from duodenal ulcer. The parameters that differentiated to a statistically significant degree the peptic ulcer patients from either one or both groups of controls were: (a) neuroticism, (b) trait and state anxiety, (c) guilt, (d) general psychopathology, and (e) stressful life events. Additionally, more than 50% of patients had at least one first-degree relative with peptic ulcer. These observations indicate that psychopathological, psychosocial, characterological and hereditary factors are important pathogenetic contributors in peptic ulcer.
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PMID:Peptic ulcer in adults. Psychopathological, environmental, characterological and hereditary factors. 683 87

There is little absolute data in the form of prospective studies in patients with specific illnesses who are on oral contraceptives (OCs). Consequently, the clinician must depend on well-founded empiric decisions in prescribing the pill for these patients. The basis for the decision should be a firm understanding of the pathophysiology and laboratory effects of OCs. This needs to be juxtaposed with an understanding of the efficacy and effects of the estrogen and progestational components of the birth control pill and their interactions with maintenance medications. Available evidence is reviewed for the following medical disorders: central nervous system disorders (depression, Wilson's disease, headaches, epilepsy, multiple sclerosis, and the eye); immunologic and connective tissue diseases; diseases of the endocrine system, the gastrointestinal system, the genitourinary system, the memopoietic system; and skin disorders. 7% of women on OCs have increased or newly reported depression. Whether these are primarily psychogenic or metabolically derived is yet to be definitively determined. Wilson's disease can be exacerbated by OCs because of increased plasma ceruloplasmin and increased absorption of copper from the gastrointestinal tract. Headaches can be either a vague or a specific symptom, such as migraines, but 1/3 of these patients will become worse on OCs. There is good evidence that the headaches are caused by falling estrogen levels. There is no good evidence that epilepsy, in general, becomes worse on OCs. OCs have relatively no effect on the longterm prognosis in multiple sclerosis. Increased corneal sensitivity has been observed with OC use, and this has usually presented an intolerance to the use of contact lenses. This is primarily the result of increased edema of the cornea and changing of its contour. By inference, OCs cause some basic universal changes in the immunologic system. OCs have been reported as a cause of a rare form of rheumatoid arthritis, but the Royal College reports a decrease in incidence of cell-mediated immunologic disease, specifically rheumatoid arthritis in its more familiar form. There is no evidence that OCs markedly influence thyroid disease, but they do markedly alter thyroid function testing. OCs do not produce a chronic addisonian state nor do they inhibit the ability of the adrenal-pituitary axis to respond to stress. OCs can be used in thyroid disease but with some caution in hypothyroid states. They should not be used in patients with Cushing's syndrome and are not recommended in patients with adenomas. In general, estrogen works as an irritant to the gastric mucosa, but there is no increase in peptic ulcer diseases associated with OC use, and the incidence of duodenal ulcer disease is decreased. The most striking liver disease seen with OCs is cholelithiasis. The incidence is increased 2-fold. OCs should not be prescribed for patients with chronic renal disease because of the vascular effects as well as the reported increased risk of urinary tract infection. The Royal College report has shown a decreased incidence of iron deficiency anemia in patients on OCs. Various skin changes have been reported in women using OCs. The most common of these is chloasma. In all the diseases studied thus far, the use of OCs has not precipitated a catastrophic change.
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PMID:The use of birth control pills in women with medical disorders. 702 14

Gastric ulcer scars, which imply previous peptic ulcer disease, are visible with moderate frequency during double-contrast examinations. This article investigates the radiographic appearance of gastric ulcer scars and the frequency of their occurrence in two differing patient populations. Results with 35 gastric ulcers that were followed to healing indicate that most ulcer scars appear as folds converging toward the ulcer site, at times accompanied by a central depression and/or gross deformity of the stomach. Two series of 200 patients each who underwent double-contrast examinations suggest a 1 to 4% incidence of ulcer scars, dependent upon the population examined.
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PMID:Gastric ulcer scars. 724 41

The effect of chronic illness on the subjective quality of sleep, and the use of hypnotics was studied in a stratified random sample of elderly people. Six hundred subjects aged 65 years or over were included in the study. A structured interview on the quality of sleep and medical history was carried out. In addition, the majority of diagnoses were confirmed from the national health insurance documents of the subjects. Logistic regression analysis disclosed that only perceived poor health and peptic ulcer or esophagitis were associated with perceived poor sleep. Age did not contribute to the quality of sleep. Age over 80 years and the presence of peptic ulcer or esophagitis, heart failure, cholelithiasis, and, in particular, depression were associated with the habitual use of hypnotics. The results stress the importance of perceived poor general health status, and acid-related gastrointestinal diseases as the determinants of subjective poor sleep, rather than age or many specific somatic diseases as such. On the other hand, depression is a major determinant for the habitual use of hypnotics.
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PMID:Chronic illness and subjective quality of sleep in the elderly. 791 36

The subject of aged people and stress was discussed from both clinical and basic points of view, mainly by introducing our research results, beginning with our immunoneuroendocrine studies on aging and stress. Stress stimulates the secretion of two adrenal hormones, cortisol and dehydroepiandrosterone-sulfate (DHEA-S). Both hormones are metabolized and excreted from the kidney, respectively converting to 17-OHCS and 17-KS-S in the urine. We have found that the two adrenal steroids reflect the physiology and pathophysiology of stress and aging, thereby suggesting that the simultaneous analysis of these parameters could be utilized as new biological markers for stress and aging. It was speculated that a disturbed balance between cortisol and DHEA-S would result in various aging- and stress-related disorders. Furthermore, clinical problems in aged people with stress-related diseases such as psychosomatic diseases, neurosis and depression were illustrated by some interesting cases. In particular, much data about peptic ulcer disease in the aged, a typical psychosomatic disease, were presented. In addition, clinical characteristics of old people with irritable bowel syndrome, aerophagia, neurogenic abdominal distention and depression were described. Data of our research to determine why pancreatic cancer is accompanied with depression so frequently were also presented. Finally, it was emphasized that a holistic approach, paying to sufficient attention to psychosomatic aspects, is very important for the management of stress diseases in the aged.
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PMID:[Aged people and stress]. 802 98

Immunoreactive-somatostatin (ir-SS) concentrations of the gastric mucosa and mood state in patients with functional dyspepsia were examined. The subjects were 12 patients with upper abdominal discomfort, nausea and/or vomiting (motility disorder group) and 14 patients complaining of upper abdominal pain (ulcer-like disorder group) for more than a month without any organic upper-gastrointestinal tract disease proven by endoscopy. These patients were compared with either an age- and sex-matched group of asymptomatic outpatients without any organic disease (control group: n = 26) or to a group of patients with peptic ulcer (n = 19). Somatostatin concentrations of the stomach were measured by radio-immunoassay, and the mood state of each subject was assessed by Manifest Anxiety Scale (MAS) and Self-rating Depression Scale test. Immunoreactive-somatostatin concentrations of the gastric mucosa were significantly higher in the ulcer-like disorder group than in the peptic ulcer, motility disorder or control group, and gastric juice levels were higher in the ulcer-like disorder group. The psychometric tests showed that the motility disorder group was more depressive than the ulcer-like disorder group, but there were no differences between the motility disorder, ulcer-like disorder and peptic ulcer group in MAS scores or environmental factors. These results indicate that there may be two different subgroups in functional dyspepsia influenced by both ir-SS concentration of the stomach and/or mood state.
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PMID:Immunoreactive-somatostatin concentrations of the human stomach and mood state in patients with functional dyspepsia: a preliminary case-control study. 810 48

The inadequacy of pain treatment has been demonstrated in many patient groups suffering from acute pain. The injectable nonsteroidal anti-inflammatory drugs (NSAIDs), including indomethacin, diclofenac, ketoprofen and ketorolac, provide relief from the pain associated with several different conditions. When administered alone or in combination with low doses of opioids, NSAIDs provide good pain relief after musculoskeletal trauma or operation. The main advantage of these agents is that they may form the first-line therapy for pain relief and thus decrease the need of opioids. This avoids respiratory depression which can be associated with opioids. In contrast to opioids, NSAIDs do not cause respiratory depression or have marked adverse effects on the central nervous system. However, they may be associated with adverse effects of the gastrointestinal tract, liver and kidneys, and may increase pre- and postoperative bleeding and cause allergic reactions. These effects are related to the ability of NSAIDs to inhibit prostaglandin synthesis. Use of NSAIDs has to be considered carefully in patients with asthma, allergy to aspirin and NSAIDs, atopy, peptic ulcer or bleeding disorders (such as abnormalities in blood coagulation or coagulation deficits). These considerations are especially important in elderly patients. Having taken these contraindications into account, many clinical studies have demonstrated that NSAIDs are at least as safe as opioids when administered in the short term. However, few studies have specifically monitored adverse effects or included patients over 65 to 70 years of age. In addition, patients with risk factors have often been excluded from the trials. Therefore, the risk-benefit ratio of NSAIDs requires further assessment.
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PMID:A risk-benefit appraisal of injectable NSAIDs in the management of postoperative pain. 828 Apr 5

The study material consisted of 487 subjects from a stratified random sample of the non-institutionalized population of Turku aged 65 years or more (n = 24,937). The study was based on a population study on health status and sleeping habits of the elderly. Information on health status and medications was obtained by means of interviews and from the national health insurance records of the subjects. A postal questionnaire inquired about symptoms suggestive of gastroesophageal reflux disease (GERD). In univariate analyses, perceived poor health, insomnia, disability, depression, previous peptic ulcer, cholelithiasis, and bronchial asthma were associated with daily symptoms suggestive of GERD. Moreover, the symptoms were associated with the use of beta-blocking agents, benzodiazepines, and neuroleptic agents. In multivariate analyses, previous peptic ulcer, perceived poor health, insomnia, and use of benzodiazepines were independently associated with symptoms suggestive of GERD. In conclusion, the determinants of symptoms suggestive of GERD in the elderly differ from those reported in young and middle-aged subjects.
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PMID:Determinants of symptoms suggestive of gastroesophageal reflux disease in the elderly. 828 23

We have investigated the complications, toxicities, tumor response and survival rate with hepatic arterial (HA) chemotherapy for liver metastases from colorectal cancer. Forty-three patients with measurable liver metastases and 10 patients after the resection of liver metastases were treated with HA bolus mitomycin C (MMC) or continuous fluorouracil (5-FU) infusion between 1986 and 1994. The catheter- or reservoir-related complications such as catheter induced infection, subcutaneous reservoir pocket infection, or catheter or hepatic artery occlusion occurred in 14 patients (26%) mainly in our early cases. Severe gastritis or a gastroduodenal ulcer developed in 12 patients (23%), in particular after treatment with continuous infusion of 5-FU and when the catheter was placed into the gastroduodenal artery during laparotomy. An ulcer often caused a serious complication such as a duodeno-biliary fistula, penetration into the hepatic artery or duodenal perforation. Also noted were upper gastrointestinal symptoms in 26 patients, hepatic toxicities in 3 patients, and bone marrow depression in 4 patients. Because of these complications and toxicities, HA therapy was discontinued in more than 60% of the cases. The overall tumor response rate was 17%. However, in the cases which were treated by 5-FU continuous infusion for longer than 3 months, the response rate was higher than 60%. There was no significant difference in survival rate between HA therapy and systemic palliative chemotherapy. These results suggest that it is important to prevent gastrointestinal toxicities in order to allow continuation of HA continuous 5-FU infusion therapy which could provide a higher response rate and a better survival for colorectal cancer patients with liver metastases.
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PMID:Hepatic arterial chemotherapy for liver metastases from colorectal cancer. 870 58

There is ample empirical evidence supporting the view of emotional disturbances in children with recurrent abdominal pain (RAP) as well as in their parents. However, controlled studies have reported that such manifestations can also be found in patients with other chronic ailments. In order to characterize further the nature of emotional factors in RAP patients, we conducted a controlled psychological evaluation of 46 consecutive new patients with RAP, aged 7-17 years, (group A) by means of structured interviews and questionnaires. Two control groups of pediatric patients with chronic illnesses were also assessed using the same methodology. Group B consisted of 22 individuals with chronic abdominal pain and endoscopy-proven peptic ulcer or duodenitis, and group C consisted of 24 individuals with chronic, stable, non-gastroenterological diseases (e.g., diabetes mellitus or physical handicaps). Parents were evaluated for depressive symptoms. One-way analysis of variance and contingency tables were used for statistical comparisons. There was a higher proportion of female patients in group A than in group B (70 vs 41%; p < 0.05). There were significantly more patients in group A than in group B that reported that their abdominal pain: a) never appeared during sleep, b) began soon after the patient's arousal in the morning, c) remitted completely or was alleviated during school holidays, d) its remission was usually spontaneous during the day and e) did never interfere with recreational activities. Emotional problems were significantly more prevalent in patients in group B than in those in group A (p = 0.016). Past diagnosis of depression was more frequent in group A mothers (40%) than in those in group B (27%), or group C (17%), but these differences did not attain statistical significance. These results suggest that psychological profiles of children suffering from certain chronic conditions (and those of their parents) may be more complex and particular than hitherto recognized. The role of type II error and of some potential socioeconomic and demographic confounding factors must be considered when analyzing the validity of these data.
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PMID:[Clinical and psychological characterization of children and adolescents with recurrent abdominal pain]. 873 76


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